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Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.

INTRODUCTION: Catatonia is a syndrome characterized by physical symptoms ranging from immobility to excessive motor activity. Besides being historically associated mainly with schizophrenia, it is widely known that it can be the expression of different psychiatric, neurological or medical conditions...

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Autores principales: Bueno Sanya, L., Andreu Gracia, H., De Juan Viladegut, O., Olivier Mayorga, L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10479704/
http://dx.doi.org/10.1192/j.eurpsy.2023.2264
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author Bueno Sanya, L.
Andreu Gracia, H.
De Juan Viladegut, O.
Olivier Mayorga, L.
author_facet Bueno Sanya, L.
Andreu Gracia, H.
De Juan Viladegut, O.
Olivier Mayorga, L.
author_sort Bueno Sanya, L.
collection PubMed
description INTRODUCTION: Catatonia is a syndrome characterized by physical symptoms ranging from immobility to excessive motor activity. Besides being historically associated mainly with schizophrenia, it is widely known that it can be the expression of different psychiatric, neurological or medical conditions. The treatment of choice is benzodiazepines, indicating electroconvulsive therapy in refractory cases. Amantadine is considered a second-line therapy in setting when electroconvulsive therapy is not available. OBJECTIVES: To describe the case of a patient with treatment-resistant catatonic schizophrenia. Not having responded to benzodiazepines or electroconvulsive therapy, potentiation with amantadine was subsequently started. METHODS: Our patient presented at a psychopathological level; psychomotor inhibition, a perplexing attitude, and mute speech. At the motor level; ambitendency, indecision, automatic obedience, motor stereotypes, and facial grimaces. He did not present other alterations at the neurological level. Regarding complementary explorations, we performed neuroimaging and blood tests, which resulted all anodyne. With an alternative diagnosis, we considered that sequelae of a neuroleptic malignant syndrome could have produced the symptoms that he had suffered. Due to the persistence of the symptoms and their typical characteristics, catatonia was our first diagnostical impression. As treatment with benzodiazepines was ineffective, electroconvulsive therapy was started. No clinical improvement was observed. Given the refractoriness of the case, a review of the existing literature was carried out. We found reports of a good response to amantadine in similar cases. Amantadine was introduced up to a dose of 200mg. RESULTS: After four weeks of treatment with amantadine at a dose of 200mg, the patient showed meager improvement at both psychopathological and motor level. CONCLUSIONS: We find the case of a patient with long-term schizophrenia who is nowadays dependent on all daily living activities and requires sustained care. DISCLOSURE OF INTEREST: None Declared
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spelling pubmed-104797042023-09-06 Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report. Bueno Sanya, L. Andreu Gracia, H. De Juan Viladegut, O. Olivier Mayorga, L. Eur Psychiatry Abstract INTRODUCTION: Catatonia is a syndrome characterized by physical symptoms ranging from immobility to excessive motor activity. Besides being historically associated mainly with schizophrenia, it is widely known that it can be the expression of different psychiatric, neurological or medical conditions. The treatment of choice is benzodiazepines, indicating electroconvulsive therapy in refractory cases. Amantadine is considered a second-line therapy in setting when electroconvulsive therapy is not available. OBJECTIVES: To describe the case of a patient with treatment-resistant catatonic schizophrenia. Not having responded to benzodiazepines or electroconvulsive therapy, potentiation with amantadine was subsequently started. METHODS: Our patient presented at a psychopathological level; psychomotor inhibition, a perplexing attitude, and mute speech. At the motor level; ambitendency, indecision, automatic obedience, motor stereotypes, and facial grimaces. He did not present other alterations at the neurological level. Regarding complementary explorations, we performed neuroimaging and blood tests, which resulted all anodyne. With an alternative diagnosis, we considered that sequelae of a neuroleptic malignant syndrome could have produced the symptoms that he had suffered. Due to the persistence of the symptoms and their typical characteristics, catatonia was our first diagnostical impression. As treatment with benzodiazepines was ineffective, electroconvulsive therapy was started. No clinical improvement was observed. Given the refractoriness of the case, a review of the existing literature was carried out. We found reports of a good response to amantadine in similar cases. Amantadine was introduced up to a dose of 200mg. RESULTS: After four weeks of treatment with amantadine at a dose of 200mg, the patient showed meager improvement at both psychopathological and motor level. CONCLUSIONS: We find the case of a patient with long-term schizophrenia who is nowadays dependent on all daily living activities and requires sustained care. DISCLOSURE OF INTEREST: None Declared Cambridge University Press 2023-07-19 /pmc/articles/PMC10479704/ http://dx.doi.org/10.1192/j.eurpsy.2023.2264 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Abstract
Bueno Sanya, L.
Andreu Gracia, H.
De Juan Viladegut, O.
Olivier Mayorga, L.
Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
title Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
title_full Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
title_fullStr Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
title_full_unstemmed Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
title_short Amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
title_sort amantadine augmentation in electroconvulsive therapy-resistant catatonia: a case report.
topic Abstract
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10479704/
http://dx.doi.org/10.1192/j.eurpsy.2023.2264
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